Provider enrollment professionals are knowledgeable about this application process and can streamline it for the provider. They can also act as the point of contact between the provider and the insurance network, follow-up on applications and resolve any issues that may occur between the provider and the insurance company. Hiring an enrollment professional takes the worry and stress out of filling out the forms, which allows the providers to do what they do best – care for patients.

Credentialing licensed medical professionals is the process of collecting, verifying and evaluating education, work history, staff privileges, licensures, malpractice insurance as well as maintaining and documenting current education requirements.

The organization and ongoing maintenance of Hospitals Initial and Reappointment Applications, Commercial Insurance Plans (Third Party Payors), Medicare and Medicaid Initial Applications, Re-credentialing and Revalidation Applications as well as CAQH set-up and maintenance.

Credentialing Experts, Inc. treats all documents as confidential and subject to current HIPAA and other regulatory statutes. No information is shared unless authorized. All staff members are bound by a signed confidentiality agreement that is strictly enforced.

Credentialing Experts, Inc. is very aware of the need to protect our clients’ information from unauthorized release. In order to ensure the security of this information we have implemented three layers of information security.

FIRST LAYER – a physical firewall which provides a single device that integrates comprehensive Enterprise-grade Network Security protection. This comprehensive network security includes Application Control, IPS (Intrusion Protection), Advanced Anti-Malware, Web Filtering and encrypted VPN Access with automated security updates to ensure up-to-date protection. This provides electronic data protection compliance with PCI, HIPAA and GLBA regulations. Our encrypted email service allows for timely and secure communication of sensitive information with our clients.

SECOND LAYER – safeguards the internal electronic components with software to provide an Anti-Virus, Anti-Malware, Network attack blocking and web protection as well as protection of our servers. This software also provides device control preventing malware entering through removable media such as infected cd/dvd/flash drives.

THIRD LAYER – consists of facility security. We are located in an entry controlled facility with separate office entry control. Our client files are secured under lock when not in use. Our computers are strong password protected with individual user control and logging. Our firewall, antivirus and security logs are reviewed by trained personnel to identify and mitigate penetration attempts.